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Home My WebLink About200 N. COLLEGE LLC - INSURANCE CERTIFICATEACOR15m CERTIFICATE OF LIABILITY INSURANCE lh..� 6/1/2019 DATE(MM/DD/YYYY) 1 5/22/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 8110 E Union Avenue Suite 700 Denver CO 80237 NAME: CONTAZT PHONE A/C, No, Ext : A/C, No E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: The Travelers Indemnity Company 25658 INSURED 200 N. College, LLC 1430351 200-207 N College Avenue Fort Collins, CO 80524 INSURER B : Ironshore Indemnity Inc. 23647 INSURER C : ACE Property & Casualty Insurance Co 20699 INSURER D: Pinnacol Assurance Company 41190 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 15479924 REVISION NUMBER- XXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM D/YYYY POLICY EXP MM/D /YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y N Y-630-9K213399-IND-19 5/20/2019 5/20/2020 EACH OCCURRENCE 1,000, 000 CLAIMS -MADE F OCCUR PREMISES Ea occurrence 100,000 X MED EXP (Any oneperson) 5,000 Terrorism Included PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY❑ PRO- O - X❑ LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG S 2,000,000 $ OTHER: AUTOMOBILE LIABILITY ANY AUTO NOT APPLICABLE COMBINED SINGLE LIMIT Ea accident $ XXXXXXX BODILY INJURY (Per person) $ XXXXXXX AAUTOS ONLY SCHEDULED BODILY INJURY (Per accident $ XXXXXXX AUTOS ONLY AUUTOSONLY PROPERTY DAMAGE $ XXXXXXX B X UMBRELLA LIAB X OCCUR Y N HL118-A-G71364409 5/20/2019 5/20/2020 EACH OCCURRENCE $ 50,000,000 C EXCESS LIAB CLAIMS -MADE HL118 A-G71364409 5/20/2019 5/20/2020 X AGGREGATE $ 50,000,000 DED I X I RETENTION $ I0,000 $ XXXXXXX D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N OFFICER/MEMBER EXCLUDED? N❑ (Mandatory in NH) it yes, describe under DESCRIPTION OF OPERATIONS below N / A I N I I 4093547 6/1/2018 6/1/2019 I PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If the General Liability polic( is cancelled by the issuing company during the policy tenn, for other than non-payment of prenliunt, 30 days' notice will be provided to the Certificate Holder named be ow, 10 days' for non -Payment of premium. Excess Liability Is following form to the General Liability and includes Terrorism. RE: The Exchange - 200-207 N College Ave, Fort Collins, CO 80524. Liquor Liability: Aggregate Limit: $2.000,000. Each Common Cause Limit; $1,000,000. City- of Fort Collins is included as Additional Insured as respects to General Liability if required by written contract. v�r� � �� vn r � � ry LULr� I.M IY IiGLLN 1 IVIY 15479924 City of Fort Collins PO Box 280 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) ©1988-2015 ACORD CORP61RATION_ All rinhta rpsprvari The ACORD name and logo are registered marks of ACORD